Remote Case Management Associate - Healthcare Coordination

CVS Health; Richmond (VA); Remote; USD 25,000 - 49,000; Full time

Benefits offered by this job

Benefits package

Bonus / incentive program

Work-from-home

Job summary

CVS Health is hiring a Care Management Associate (CMA) to support comprehensive coordination of medical services, intake, screening and implementation of care plans to promote efficient healthcare use. You will assist in triaging Care Team tasks and coordinating referrals within the benefit plan.

Responsibilities include ensuring compliant documentation, utilizing care-management tools, and collaborating with nurses and medical directors to optimize care delivery while maintaining HIPAA

Qualifications

• 1-3 years in healthcare/medical role.
• Strong customer service to coordinate service delivery.
• 1-3 years with Outlook, Word, and Excel.

Responsibilities

• Review and triage Care Team tasks.
• Identify reasons for admission and apply intervention tools.
• Coordinate needed medical services and referrals.
• Monitor non-targeted cases and update discharge dates.
• Refer outlier cases to clinical staff.
• Identify triggers for referral to Case/Disease Management.
• Use eTUMS and other CVS/Aetna systems for member data.
• Develop and implement care plans under supervision.
• Coordinate care delivery in appropriate settings to minimize costs.
• Promote internal and external communication for care delivery.
• Maintain compliant documentation and confidentiality.
• Support research and resolution of claims issues.
• Assist in hospital care, case management and quality processes.

Skills

Customer service

Healthcare experience

MS Outlook

MS Word

MS Excel

Care coordination

Education

High School diploma / GED

Tools

Microsoft Office 365

Job description

CVS Health is hiring a Care Management Associate (CMA) to support comprehensive coordination of medical services, intake, screening and implementation of care plans to promote efficient healthcare use. You will assist in triaging Care Team tasks and coordinating referrals within the benefit plan.

Responsibilities include ensuring compliant documentation, utilizing care-management tools, and collaborating with nurses and medical directors to optimize care delivery while maintaining HIPAA